Reliability of the VmaxST portable metabolic measurement system

Self-paced and fixed speed treadmill walking yield similar energetics and biomechanics across different speeds

BACKGROUND

Treadmill assessments are often performed at a fixed speed. Feedback-controlled algorithms allow users to adjust the treadmill speed, hereby potentially better resembling natural self-paced locomotion. However, it is currently unknown whether the energetics and biomechanics of self-paced differ from fixed-paced treadmill walking. Such information is important for clinicians and researchers using self-paced locomotion for assessing gait.

RESEARCH QUESTION

To investigate whether energy cost and biomechanics are different between self-paced and matched-speed fixed-paced locomotion.

METHODS

18 healthy participants (9 males/9 females, mean ± standard deviation age 24.8 ± 3.3 years, height 1.71 ± 0.81 m, weight 65.9 ± 8.1 kg) walked at four different self-paced speeds (comfortable, slow, very slow, fast) in randomized order on an instrumented treadmill while three-dimensional motion capture and gas exchange were measured continuously. The average walking speed during the last 2 min of the self-paced trials was used to match the speed in fixed-paced conditions. Linear mixed models were used to assess differences in mean values and within-subject variations between conditions (self-paced and fixed-paced) and speeds. Statistical Parametric Mapping was used to assess differences in kinematics of the lower limb between conditions.

RESULTS

Although self-paced walking consistently resulted in a 4-6% higher net cost of walking, there were no significant differences in the net cost of walking between conditions. Further, there were also no differences of clinical relevance in spatiotemporal outcomes and sagittal-plane lower-limb kinematics between the self-paced and fixed-paced conditions. Within-trial variability was also not significantly different between conditions.

SIGNIFICANCE

Self-paced and fixed-paced treadmill walking yield similar energetics and kinematics in healthy young individuals when mean values or linear measures of variation are of interest.

Validity and Reliability of the VO2 Master Pro for Oxygen Consumption and Ventilation Assessment

This study assessed validity and reliability of the VO2 Master Pro portable metabolic analyzer for assessment of oxygen consumption (VO2) and minute ventilation (VE). In Protocol 1, eight male participants (height: 182.6 ± 5.8 cm, weight: 79.6 ± 8.3 kg, age: 41.0 ± 12.3 years) with previous competitive cycling experience completed an hour-long stationary cycling protocol twice, progressing from 100-300 Watts every 10 minutes while wearing the VO2 Master and a criterion measure (Parvomedics) for five minutes each, at each stage. In Protocol 2, 16 recreationally active male participants (height: 168.2 ± 8.4 cm, weight: 76.5 ± 13.3 kg, age: 23.0 ± 9.4 years) completed three incremental, maximal stationary cycling tests wearing one of three analyzers for each test (VO2 Master version 1.1.1, VO2 Master version 1.2.1, Parvomedics). For Protocol 1 and convergent validity, the VO2 Master had mean absolute differences from the Parvomedics of <0.3 L/min for absolute VO2 and <5 L/min for VE overall and at each exercise stage. Mean absolute percent differences (MAPD) for VO2 and VE were <9% overall and <12% at each stage. Test-retest reliability of the VO2 Master (MAPD: 8.9-10.9%) was somewhat poorer than the Parvomedics (MAPD: 5.3-7.6%). For Protocol 2, validity was similar for both VO2 Master models (MAPD ~12% overall) compared to the Parvomedics for VO2 and VE. The VO2 Master had an acceptable validity and test-retest reliability for most intensities tested and may be an appealing option for field-based VO2 and VE analysis.

Inter-individual variability in load carriage economy and comparisons between different load conditions

Equivocal findings exist for the economy associated with load carried close to the body's centre of mass. Individual variation could explain some of the equivocal findings. This research aimed to examine the extent of individual variation in loaded walking economy. Eighteen females carried load on the back, head and split between the front and back. Individual variation in relative load carriage economy (ELI) was primarily assessed using standard deviation, coefficients of variation (CV) and intraclass correlation coefficients (ICC). There was large inter-individual variation in ELI values with highest mean CV's of 16%, 12% and 10% for head-, back- and combined front and back-loading. Mean ELI values were not significantly different between methods. The large amount of individual variation found here suggests future load carriage research should account for individual variation, particularly when considering sample size and when making inferences on the economy associated with different types of load carriage using group mean data.

Open-circuit respirometry: a historical review of portable gas analysis systems

Scientists such as physiologists, engineers, and nutritionists have often sought to estimate human metabolic strain during daily activities and physical pursuits. The measurement of human metabolism can involve direct calorimetry as well as indirect calorimetry using both closed-circuit respirometry and open-circuit methods that can include diluted flow chambers and laboratory-based gas analysis systems. For field studies, methods involving questionnaires, pedometry, accelerometery, heart rate telemetry, and doubly labelled water exist, yet portable metabolic gas analysis remains the gold standard for most field studies on energy expenditure. This review focuses on research-based portable systems designed to estimate metabolic rate typically under steady-state conditions by critically examining each significant historical innovation. Key developments include Zuntz's 1906 innovative system, then a significant improvement to this purely mechanical system by the widely adopted Kofranyi-Michaelis device in the 1940s. Later, a series of technical improvements: in electronics lead to Wolf's Integrating Motor Pneumotachograph in the 1950s; in polarographic O₂ cells in 1970-1980's allowed on-line oxygen uptake measures; in CO₂ cells in 1990s allowed on-line respiratory exchange ratio determination; and in advanced sensors/computing power at the turn of the century led to the first truly breath-by-breath portable systems. Very recent significant updates to the popular Cosmed and Cortex systems and the potential commercial release of the NASA-developed 'PUMA' system show that technological developments in this niche area are still incrementally advancing.

Test-retest reliability and minimum detectable change using the K4b2: oxygen consumption, gait efficiency, and heart rate for healthy adults during submaximal walking

PURPOSE

Oxygen consumption (VO2; mLO2/kg/min), gait efficiency (GE; mlO2/kg/m) and heart rate (HR; beats per minute) are measures of physiological gait performance. However, the collection device, procedures for data normalization, and biological factors can affect measurement variability. The purpose of this study was to determine the test-retest reliability and minimum detectable change (MDC) for VO2, GE, and HR with the K4b2 at submaximal walking speeds in healthy young adults. A second purpose was to determine if net measures improved reproducibility.

METHOD

Twenty-two participants completed 2 identical treadmill tests on separate days at submaximal walking speeds from 0.71 m/s to 1.65 m/s.

RESULTS

Intraclass correlation coefficient (ICC) values for gross VO2, gross GE, and HR were greater than .85 for all walking speeds. Associated MDC values were approximately 7% to 10% for gross VO2 and GE, and approximately 9% to 12% for HR. ICC values for resting VO2 were lower, with MDC values approaching 25%. Subtracting out resting values to derive net VO2 and GE values produced ICC values below .76 for the 2 slowest speeds but ICC values greater than .83 for the faster speeds. MDC values for net VO2 and GE were up to 20% for the slowest speeds.

CONCLUSIONS

The results demonstrate metabolic cost can be assessed reliably using the K4b2 during submaximal walking and that gross measures are more reliable than net measures. Furthermore, changes at self-selected speeds exceeding 1.0 mLO2/kg/min in gross VO2 and 0.01 mLO2/kg/m in gross GE can be considered a true change in walking performance.

Repeatability of aerobic capacity measurements in Parkinson disease

PURPOSE

Maximal or peak aerobic capacity (VO(2peak)) during a maximal-effort graded exercise test is considered by many to be the "gold standard" outcome for assessing the effect of exercise training on cardiorespiratory fitness. The reliability of this measure in Parkinson disease (PD) has not been established, where the degree of motor impairment can vary greatly and is influenced by medications. This study examined the reliability of VO(2peak) during a maximal-effort graded exercise test in subjects with PD.

METHODS

Seventy healthy middle-aged and older subjects with PD Hoehn and Yahr stage 1.5-3 underwent a screening/acclimatization maximal-effort treadmill test followed by two additional maximal-effort treadmill tests with repeated measurements of VO(2peak). A third VO(2peak) test was performed in a subset of 21 subjects.

RESULTS

The mean VO(2peak) measurement was 2.4% higher in the second test compared with the first test (21.42 ± 4.3 vs 21.93 ± 4.50 mL·kg(-1)·min(-1), mean ± SD, P = 0.03). The intraclass correlation coefficients (ICC) for VO(2peak) expressed either as milliliters per kilogram per minute or as liters per minute were highly reliable, with ICC of 0.90 and 0.94, respectively. The maximum HR (ICC of 0.91) and final speed achieved during the tests (ICC of 0.94) were also highly reliable, with the respiratory quotient being the least reliable of the parameters measured (ICC of 0.65).

CONCLUSIONS

Our results demonstrate that measurement of VO(2peak) is reliable and repeatable in subjects with mild to moderate PD, thereby validating use of this parameter for assessing the effects of exercise interventions on cardiorespiratory fitness.

Measurement of human energy expenditure, with particular reference to field studies: an historical perspective

Over the years, techniques for the study of human movement have ranged in complexity and precision from direct observation of the subject through activity diaries, questionnaires, and recordings of body movement, to the measurement of physiological responses, studies of metabolism and indirect and direct calorimetry. This article reviews developments in each of these domains. Particular reference is made to their impact upon the continuing search for valid field estimates of activity patterns and energy expenditures, as required by the applied physiologist, ergonomist, sports scientist, nutritionist and epidemiologist. Early observers sought to improve productivity in demanding employment. Direct observation and filming of workers were supplemented by monitoring of heart rates, ventilation and oxygen consumption. Such methods still find application in ergonomics and sport, but many investigators are now interested in relationships between habitual physical activity and chronic disease. Even sophisticated questionnaires still do not provide valid information on the absolute energy expenditures associated with good health. Emphasis has thus shifted to use of sophisticated pedometer/accelerometers, sometimes combining their output with GPS and other data. Some modern pedometer/accelerometers perform well in the laboratory, but show substantial systematic errors relative to laboratory reference criteria such as the metabolism of doubly labeled water when assessing the varied activities of daily life. The challenge remains to develop activity monitors that are sufficiently inexpensive for field use, yet meet required accuracy standards. Possibly, measurements of oxygen consumption by portable respirometers may soon satisfy part of this need, although a need for valid longer term monitoring will remain.

Walking and running economy: inverse association with peak oxygen uptake

PURPOSE

The purpose of this study was to test the hypothesis that V˙O2peak is positively correlated with the regression coefficients of the curve-linear relationship between V˙O2 and speed during a protocol consisting of submaximal walking and running.

METHODS

Nineteen healthy men (mean ± SD: age = 26.4 ± 6.4 yr, height = 179.9 ± 7.2 cm, weight = 77.7 ± 8.7 kg, % fat = 16.3 ± 7.3) and 21 healthy women (age = 25.6 ± 4.9 yr, height = 167.2 ± 5.4 cm, weight = 61.6 ± 7.7 kg, % fat = 24.0 ± 6.8) underwent an incremental treadmill test to determine VO2peak and on two separate days performed an exercise protocol consisting of treadmill walking on a level grade at 2.0 mph (54 m·min−¹), 3.0 mph (80 m·min−¹), and 4.0 mph (107 m·min−¹) and running at 6.0 mph (161 m·min−¹). Subjects exercised for 5 min at each velocity, with 3 min of rest in between each exercise bout. Pulmonary ventilation (VE) and gas exchange were measured breath-by-breath each minute. The average of VO2 values obtained during the last 2 min of exercise for both exercise sessions was used in polynomial random coefficient regression analysis.

RESULTS

In the polynomial random coefficient regression analysis for walking speeds only, both linear (r = 0.31, P = 0.053) and quadratic (r = 0.35, P = 0.029) coefficients were modestly correlated with VO2peak. Steady-state VO2 during walking at 3.0 and 4.0 mph and running at 6.0 mph was also modestly correlated with VO2peak (r = 0.30-0.48).

CONCLUSIONS

The results confirm our hypothesis and suggest that, as walking speed increases, the increase in VO2 is positively correlated with the VO2peak. Our findings are consistent with the notion that cardiorespiratory fitness and exercise economy are inversely related.